We are all born with an identity, a unique character that comes from the combining of our parents’ genes and that is shaped by interactions with our mothers and fathers. Defining personal and social identity for the thousands of U.S. children born each year through artificial insemination, however, is far more complicated. And according to a recent report titled “My Daddy’s Name is Donor,” released by the Commission on Parenthood’s Future, the social and medical ramifications of anonymous sperm donation in the United States may be far more significant for donor-conceived individuals than is widely believed.

“The need to know your father, and the grief [felt] when one’s father is not in one’s life, is not a recent social construction,” explained Elizabeth Marquardt, vice president for family studies at the Institute for American Values and lead author on the report. “Our civilization’s great cultural stories, from ancient Mesopotamia through to the Bible and Shakespeare and to the present era, such as the Star Wars films (Darth Vader: ‘Luke, I am your father’), affirm the great importance to the human child of knowing and being known by his or her own father.”

The anonymous trade of sperm and eggs has become a major issue worldwide, and some countries, including Britain, Sweden, Norway, the Netherlands, New Zealand, and some parts of Australia, have banned anonymous donation. Other countries have introduced new laws guiding donation practices, including limiting the number of offspring that can be sired by a single donor and introducing registries that allow donors and offspring to find one another.

But while policies have changed elsewhere, they have received little attention in the United States. “Right now, the United States is the wild west of the world when it comes to reproductive technologies,” Marquardt said. “[Here], what law and policy does exist is designed explicitly to protect the preferred rights of parents and would-be parents and donors. The offspring have no right to know where they come from.”

Marquardt’s recent study was co-investigated with Karen Clark, an author and writer for FamilyScholars.org, and Norval D. Glenn, a professor of sociology and American studies at the University of Texas, Austin. Through a survey fielded with an online panel of more than one million American households, the researchers were able to assemble a representative sample of 485 donor-conceived persons ages 18 to 45. They also sampled comparison groups of more than 560 individuals who were adopted and more than 560 persons who were raised by their biological parents.

The researchers found that even with controls for socio-economic status, donor offspring are more than twice as likely to struggle with substance abuse and delinquency, and more than 1.5 times as likely to struggle with depression, compared to those raised by their biological parents. They also fare worse on average compared to those raised by adoptive parents.

Furthermore, some two-thirds of donor offspring believe that they should have the right to know the identity of their biological fathers. “What seems especially troubling for some donor offspring is the deliberateness with which they were denied knowledge of or a relationship with their sperm donor biological fathers,” Marquardt explained. “Before they were ever born, their mothers and others decided that this man—their father—should not be of importance to them. Moreover, the state and society affirm that decision made by others before their birth.”

Anonymous sperm donation in the United States comes with potentially devastating consequences for the physical and mental health of donor-conceived persons. Under current U.S. regulation, donors are not required to report back to sperm banks if they later discover that they carry a genetic disease that could affect their offspring. Thus, rather than preventing genetic diseases from being inherited, donor offspring affected by paternally inherited genetic diseases are left to deal with their conditions, with little if any ability to seek legal or other redress because of the protection of anonymity conferred on donors in the United States.

The lack of donor tracking also means that persons conceived via artificial insemination are unable to obtain information about half-siblings, and hence the possibility of accidental incest is very real. “The American Society of Reproductive Medicine has a professional recommendation that 25 or fewer offspring should be conceived from the sperm of any one donor, but this is only a recommendation, not a law,” Marquardt said. “And to know you could have even 25 unidentified half-siblings is mind-boggling and disturbing to people conceived in this way.”

An underlying theme in “My Daddy’s Name is Donor” is the fact that none of us have control over our born identities. “We are all here and all exist because of a union of our mothers and fathers,” Marquardt said. “But that does not mean we can have no opinion about what our parents did or did not do for us. Donor offspring are no different. They have powerful and profoundly legitimate perspectives to share as our society debates how to conceive the next generation of children.”

For more about Elizabeth Marquardt, Karen Clark, Norval D. Glenn, and “My Daddy’s Name is Donor,” see FamilyScholars.org.